       Document 0583
 DOCN  M9640583
 TI    Interstitial pneumonitis in patients infected with the human
       immunodeficiency virus.
 DT    9604
 AU    Griffiths MH; Miller RF; Semple SJ; Department of Histopathology,
       University College London Medical; School, London, UK.
 SO    Thorax. 1995 Nov;50(11):1141-6. Unique Identifier : AIDSLINE
       MED/96149316
 AB    BACKGROUND--A study was performed to identify the clinical,
       radiographic, and histopathological features of interstitial pneumonitis
       in patients infected with the human immunodeficiency virus. METHODS--A
       retrospective review was made of the case notes, chest radiographs, and
       histopathological results of seven HIV-1 antibody positive patients with
       symptomatic diffuse pulmonary disease and a pathological diagnosis of
       non-specific interstitial pneumonitis. RESULTS--All patients had
       dyspnoea, with or without cough, and chest radiographs showing diffuse
       infiltrates. The arterial oxygen tension ranged widely from 5.9 to 13.1
       kPa. The initial clinical diagnosis was Pneumocystis carinii pneumonia
       in most cases. The pathological diagnosis was made by transbronchial
       biopsy in one case and by open lung biopsy in six cases. The
       interstitial pneumonitis consisted of a patchy lymphocytic infiltrate
       composed of B cells in focal aggregates and T cells in a more diffuse
       distribution. The T cell population was a mixture of CD4+ and CD8+
       cells. The histological findings contrast with the more extensive
       infiltrate of predominantly CD8+ lymphocytes seen in HIV-associated
       lymphocytic interstitial pneumonitis which occurs mainly in children.
       The condition ran a subacute course. Three patients spontaneously
       improved and three improved with steroid therapy. Long term survival was
       less than three years, the prognosis being determined by other infective
       or neoplastic complications. CONCLUSIONS--Non-specific interstitial
       pneumonitis usually presents with an illness resembling Pneumocystis
       carinii pneumonia but occurs when the CD4 and total lymphocyte counts
       are still preserved. The pneumonitis resolves spontaneously or responds
       to steroids, and does not itself lead directly to the patient's death.
       It does, however, appear to mark a downturn in the course of HIV
       infection.
 DE    Adult  B-Lymphocytes  Human  HIV Infections/*COMPLICATIONS/MORTALITY
       Lung/PATHOLOGY  Lung Diseases, Interstitial/*DIAGNOSIS/DRUG
       THERAPY/PATHOLOGY  Male  Middle Age  Prednisolone/THERAPEUTIC USE
       Retrospective Studies  T-Lymphocytes  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

